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Pathophysiology > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

Ulcerative Colitis or Chron’s Disease?

Bloody stool

A

Ulcerative colitis

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2
Q

Ulcerative Colitis or Chron’s Disease?

Malnutrition

A

Both

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3
Q

Ulcerative Colitis or Chron’s Disease?

Weight loss

A

both

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4
Q

Ulcerative Colitis or Chron’s Disease?

Tenesmus

A

Ulcerative colitis

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5
Q

Ulcerative Colitis or Chron’s Disease?

Exacerbations and remissions

A

Both

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6
Q

Ulcerative Colitis or Chron’s Disease?

non bloody diarrhea

A

Chron’s Disease

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7
Q

Ulcerative Colitis or Chron’s Disease?

Starts at the rectum and moves towards the cecum

A

Ulcerative colitis

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8
Q

Ulcerative Colitis or Chron’s Disease?

Surgical removal of all the large intestine may be needed

A

Ulcerative colitis

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9
Q

Ulcerative Colitis or Chron’s Disease?

Cobblestone appearance with skip lesions

A

Chron’s Disease

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10
Q

Ulcerative Colitis or Chron’s Disease?

Can cause extra-intestinal symptoms

A

Both

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11
Q

True or false

Many believe that inflammatory bowel disease (IBD) has an autoimmune etiology.

A

True

There is a belief that IBD has an autoimmune cause. If you look at the drug therapy for IBD, many of the drugs (biologics) that are used now are targeting the immune system trying to calm it down.

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12
Q

Which of the following are complications of Chron’s disease that were discussed in lecture?

A

Strictures, bowel perforations, fistula formation, abscess formation

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13
Q

A patient tells the RN that they have IBS (irritable bowel disease). What does the RN understand this to mean?

A

The patient has no identifiable pathology but has a compilation of GI symptoms that affect quality of life.

IBS is a series of GI symptoms that have been present for at least 6 months. No pathology can be found on diagnostic tests. Affects about 20% of Americans.

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14
Q

Patients who have appendicitis have a particular pattern of pain. What location is the pain typically found last and the patient can point one finger to identify?

A

RLQ

The pain usually starts midline (epigastric, periumbilical or pelvic) and eventually moves to the right lower quadrant of the abdomen.

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15
Q

True or False

If a patient with appendicitis tells you that his pain is gone, that is a good sign and he probably will not need surgery.

A

False

When the pain disappears in an appendicitis patient, it usually means that the appendix ruptured. A patient with a ruptured appendix needs surgery with the peritoneal cavity washed out and antibiotics for a couple of days.

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16
Q

Which of the following statements is true about diverticular disease?

A

Diverticulitis is a serious inflammation of a diverticuli and may require hospitalization.

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17
Q

True or False

A patient is diagnosed with colon cancer in the descending colon, which is the most common site for colon cancer?

A

False

The most common site is the rectum (30%) and the sigmoid colon (25%). Between the two, over 50% of all colon cancer is found in those two locations.

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18
Q

What benefit is there for testing stool for DNA over testing just for occult blood?

A

DNA stool testing can pick up on precancerous DNA changes and possibly cancer in other parts of the GI tract.

Stool DNA testing can pick up on precancerous DNA mutations which is superior to looking for hidden blood which is a symptom of colon cancer. The procedure is similar to occult blood testing as both take a sample of stool for testing. Both can be done at home and then sent into the lab.

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19
Q

A client with diverticulitis has developed a fistula as a complication. Which of the following statements is true.

A

A fistula is a connection between two areas of the body and can be difficult to heal.

Fistulas are a complication that results in a connection between two parts of the body (ex: bowel and bladder). They form when there is an infection and I see it as the body’s way of trying to find a way to get the infection out of the body. Fistulas can be difficult to repair and heal.

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20
Q

Define choledocholithiasis

A

Stones in the common duct

Choledocho- = common bile duct (chole + docho)

-lithiasis = stone (litho)

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21
Q

Define cholecystitis

A

Inflammation of the gallbladder

Chole- = gallbladder

-cystitis = inflammation (itis)

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22
Q

Define cholangitis

A

Inflammation of the common bile duct

Chol- = gallbladder

-langitis = inflammation (itis)

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23
Q

Define cholelithiasis

A

Gallstones

Chole- = gallbladder

-lithiasis = stones (lith)

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24
Q

Gallstone pancreatitis occurs because there is a stone located in the:

A

pancreatic duct

The number one cause of acute pancreatitis is gallstones. The gallstone gets lodged into the pancreatic duct blocking the drainage of pancreatic enzymes from the pancreas.

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25
Q

Which of the following individuals has the highest risk of developing gallstones?

A

A 50-year-old Caucasian female who is overweight.

The risk factors for cholelithiasis are the 5 F’s (female, fair, fat, fertile, forty plus), middle-aged, fat, sedentary, diabetes, estrogen (HRT or OCP), pregnancy or rapid weight loss (yo-yo dieting).

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26
Q

Which of the following statements is true about pancreatitis?

A

Can result in the release of pancreatitc enzymes into the peritoneal cavity or into the general circulation.

Acute pancreatitis has a high mortality rate (10-30 %) so it should be taken seriously. Patients can quickly become very ill if the pancreatic enzymes spread into the peritoneal cavity or into the general circulation

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27
Q

Which of the following statements is true about pancreatic cancer?

A

It is the head of the pancreas that is most often involved.

The head of the pancreas is involved in 60% of cases. Because of it’s proximity to the CBD, patients often don’t present until they are jaundiced. It is often too late by that time and it has metastasized by then. The incidence of pancreatic cancer has tripled. 5% survival rate at 5 years.

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28
Q

True or False

Patients with cholecystitis always have gallstones.

A

Cholecystitis can be caused by gallstone or by “acalculous” where no stones are found. Acalculous cholecystits can be caused by trauma, DM, fasting, dehydration, opioid use, or hormone replacement therapy.

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29
Q

What -itis’ have a “chronic state”?

A

chronic cholecystitis: GB becomes fibrotic and contracted.

Chronic pancreatitis: usually from chronic alcoholism. Very painful situation and often malnourished.

Chronic gastritis: bringing this forward from the other section.

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30
Q

Which of the following can be associated with cholecystitis?

A

Biliary colic, abdominal ultrasound or CT scan for diagnosis, and right upper quadrant pain after eating that radiates to the shoulder.

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31
Q

What hepatitis?

Only exists with Hep B

A

Hep D

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32
Q

What hepatitis?

fecal-oral transmission

A

Hep A

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33
Q

What hepatitis?

leading cause of liver transplants

A

Hep C

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34
Q

What hepatitis?

most common blood/body fluid transmission

A

Hep B

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35
Q

What types of viral hepatitis causes a carrier state?

A

Hep B, C, D, and G

Hepatitis B, C, D, and G have a carrier state. Hep G doesn’t seem to cause long-term damage, but has a carrier state.

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36
Q

True or False

If a patient is very symptomatic from hepatitis, then he or she is more likely to develop chronic hepatitis

A

False

Pts with no symptoms and little immune response tend to be the ones who develop into a chronic hepatitis.

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37
Q

A patient has jaundice, therefore is most likely in which phase of the 3 phases of hepatitis?

A

Icteric phase

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38
Q

Which of the following patients is most likely to develop NASH?

A

A 40-year-old male who is obese.

NASH is nonalcoholic steatohepatitis and is related to excess energy intake that leads to fatty deposits on the liver. Caused by overeating.

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39
Q

What is the cause of jaundice in this patient?

Patient has increased unconjugated (indirect) and conjugated (direct) bilirubin. Urine dark and stool clay colored.

A

Intrahepatic jaundice

Intrahepatic jaundice causes difficulty with conjugating bilirubin as well as excreting conjugated bilirubin from the liver. Both are high. When conjugated bili is involved, then both urine and stool change colors. This would be common with cirrhosis or some other intrahepatic injury.

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40
Q

A patient with liver cirrhosis is asking the nurse why his stool floats. What is the best response by the nurse?

A

High amounts of fat in the stool

Fat in the stool makes the stool float. Bile is needed to absorb fat in the GI tract. Bile is not being made or excreted properly in cirrhosis.

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41
Q

Describe the cause of the symptom below:

The patient cannot breathe well when he lies down, he is taking diuretics (water pill) and has had a number of paracentesis treatments.

A

Ascites

He can’t breathe because of the ascites in his abdomen is limiting the expansion of his lungs.

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42
Q

What is an interesting finding in individuals who have hepatitis?

A

aversion to cigarette smoking

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43
Q

El is 27 years old and has endometriosis. What can be correlated with their occurrence of endometriosis.

A

Their mother and older sister both have endometriosis, They have not been able to become pregnant after trying for 5 years to conceive, and Their periods have been heavy with intense cramping.

The pain may be chronic (ongoing) but will follow a cyclical pattern that corresponds with the menstrual bleeding.

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44
Q

True or False

One theory is that endometriosis is caused by dormant embryonic cellular components are evolving into endometrial tissue outside of the uterus.

A

True

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45
Q

What are the classic triad symptoms of endometriosis?

A

Dsypareunia, Dysmenorrhea, and Infertility

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46
Q

A patient is asking the nurse about her symptoms of endometriosis. She asks for further clarification. What is the best response by the nurse?

A

“When the endometrial tissue bleeds outside of the uterus, it causes inflammation and scarring which leads to a lot of the pain and chronic complications.”

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47
Q

The age group that is most commonly diagnosed with endometriosis is:

A

25-35 years old

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48
Q

The cervix is normally lined with _______, whereas the vagina is lined with _______. The area where the two types of tissues come together is called the ________ zone.

A

Simple columnar epithelium, squamous epithelium, transformation

It is the transformation zone, where cells are most likely to become cancerous, so this area is inspected closely for changes.

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49
Q

True or False

Cervical cancer is a sexually transmitted disease.

A

True

This may be debated, but what I want you to walk away knowing is that 80% of all cervical cancer is caused by the human papilloma virus, which is transmitted sexually.

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50
Q

Which two types of HPV are associated with cervical cancer?

A

HPV type 16 and 18

HPV type 16 & 18 cause 80% of all cervical cancer cases. HPV 6 & 11 are associated with genital warts.

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51
Q

HPV has been associated with other cancers in addition to cervical cancer. what other types of cancers have been associated with HPV.

A

Penile, rectal, oral, and vaginal

HPV has been associated with head & neck, vaginal, vulvular, penile and rectal cancers.

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52
Q

Which of the following pathology descriptions is describing a situation that is closest to a cervical cancer diagnosis?

A

CIN3

mild dysplasia (LSIL) low grade squamous intraepithelial lesion

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53
Q

How does the body normally respond to HPV? This understanding helps explain why Pap smears should be started after age 21.

A

The body normally eradicates the virus on its own.

The screening guidelines changed to first pap at the age of 21 or 3 years after first intercourse due to many positive responses. The body normally clears HPV on its own. Delaying screening gives the body the chance to do this.

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54
Q

What are some risk factors of prostate cancer?

A

African American background, increasing age (over 65), diet high in meat and fat, and family history

Also hormonal influence and chronic inflammation

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55
Q

True or False

The symptoms of prostate cancer can look like the symptoms of benign prostatic hyperplasia.

A

True

Prostate cancer is usually asymptomatic in the early stages and then as it advances the symptoms are similar to BPH. Advanced disease can have symptoms from the metastasis.

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56
Q

What is a characteristic of prostate cancer?

A

The most common type of prostate cancer is adenocarcinoma.

Prostate CA is adenocarcinoma 95% of the time.

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57
Q

Which is a characteristic of testicular cancer?

A

Men are taught to do monthly testicular exams as a screening method.

TSE is encouraged to young men (15-35), as they are most at risk. The mass is painless and does not trans-illuminate (like a fluid fill cyst would).

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58
Q

True or False

Women with triple negative breast cancer are lucky since there is receptor targeted therapy that is quite effective.

A

False

Triple negative means Estrogen receptor, progesterone and HER2 receptor negative. This type of cancer is usually receptive to chemo, but not therapy targeted at receptors. It tends to be a more aggressive cancer with a high relapse rate.

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59
Q

What are some symptoms of breast cancer?

A

Discharge from the nipple, inversion of nipples, change in size of one breast

symptoms include: hard, uneven, painless mass; change in shape, size or feel or breast or nipple, orange peel appearance, and nipple drainage.

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60
Q

What STD?

Most characteristic symptom is a thick creamy yellow discharge, most commonly occurring in men.

A

Gonorrhea

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61
Q

What STD?

The most common sexually transmitted infection.

A

Chlamydia

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62
Q

What STD?

Very painful or itching sensation occurs prior to the presence of lesions.

A

Herpes simplex virus

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63
Q

What STD?

painless chancre lesion

A

Syphilis

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64
Q

Candidiasis infections are caused by:

A

imbalance in the normal vaginal flora

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65
Q

True or False

Herpes simplex virus infections can’t be spread unless there are lesions present.

A

False

Asymptomatic shedding of the virus still occurs even when lesions are not present. Additionally, people are always contagious when lesions are present.

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66
Q

What stage of syphilis is this?

Gummas are present in neurological system

A

Tertiary

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67
Q

What stage of syphilis is this?

painless chancre is present at site of exposure

A

Primary

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68
Q

What stage of syphilis is this?

CNS effects like dementia

A

Tertiary

69
Q

What stage of syphilis is this?

maculopapular rash on chest, palms of hands and feet present

A

Secondary

70
Q

True or False

Incontinence is a normal part of aging.

A

False

Incontinence is NOT a normal part of aging. Increasing age is a risk factor for incontinence due to weakening of pelvic floor muscles but should not be accepted as a normal part of aging and should be investigated as to the cause.

71
Q

The type of incontinence that occurs when the bladder becomes overdistended and urine leaks out is called [x]

A

Overflow Incontinence

Overflow incontinence is related to the over distension of the bladder. The bladder is full of urine and is not emptying correctly. Typical causes of this situation include chronic distension, bladder damage, or an enlarged prostate (BPH).

72
Q

A patient is telling the nurse that she better put a commode right next to the bed, because when she has urinate, the urge comes on suddenly and if she doesn’t get there quick enough, she will have an “accident”. This is called [x] incontinence.

A

Urge Incontinence

Urge incontinence is sometimes called overactive bladder. There is a strong urgency to go urinate. May be an sympathetic nervous system cause as it is common in neurological conditions.

73
Q

In [x] incontinence, there is increased pressure on the external bladder (such as increased intra-abdominal pressure from coughing) that causes the weakened urinary sphincter to not be able to hold the urine leading to leaking of urine.

A

Stress Incontinence

Stress incontinence is very common as risk factors include pregnancy, childbirth, and obesity. Urinary leaking occurs due to pressure on the bladder and a weakened urinary sphincter.

74
Q

Patient brought to the emergency room after having a seizure was found to be incontinent of urine. This type of incontinence is called [x].

A

Transient Incontinence

Transient incontinence occurs as a result of a temporary condition, such as a seizure of diuretic use.

75
Q

The nurse recognizes that many things can cause incontinence. Mark all that apply from the list below that are causes of incontinence using the DIAPPERS pneumonic.

A

Fecal impaction, delirium, UTIs, meds like diuretics

D- dementia/ delirium

I-infection (UTI)

A-atrophic vaginitis

P-pharmacological (diuretics)

P=psychological

E-endocrine (DM)

R-restricted mobility

S=stool impaction

76
Q

The most common pathological agent that causes urinary tract infections is [x], an organism that normally inhabits the gastrointestinal system.

A

E. Coli

77
Q

What are normal host defenses that try to prevent urinary tract infections.

A

Mucin layer, lactobacillus in the periurethral area, prostatic fluid has anti-microbial properties

78
Q

There is a universal push to decrease urinary catheter use in hospitalized patients to decrease the incidence of urinary tract infections. What is one factor about urinary catheters that increases the risk of urinary tract infections?

A

Formation of a biofilm on the catheter surface

bacteria adhere to the surface of the catheter and initiate growth of a biofilm that covers the surface of the catheter. The biofilm protects bacteria from the action of antibiotics and makes treatment difficult.

79
Q

A 24-year-old female patient presents with a urinary tract infection. What symptoms would the nurse expect to find?

A

Dysuria, foul smelling urine

80
Q

The nurse is reviewing the urinalysis results of a patient with a suspected urinary tract infection. The nurse recognizes which of the following findings is only present when there are white blood cells in the urine?

A

positive for leukocyte esterase

Leukocyte esterase is an enzyme that is only present when white blood cells are in the urine. It is a strong indicator of a urinary tract infection.

81
Q

An 85-year-old man is telling the nurse that he is having urinary problems. He shares that he had difficulty getting his urinary stream started and often has to push really hard for the urine to come out. He has to get up 5 times at night to go to the bathroom. He often experiences this sudden need to urinate and has to quickly find a bathroom.

What symptoms of BPH is this patient experiencing?

A

Weak urine stream, increased force needed to urinate, frequent urination at night and urgent urination

82
Q

Which of the following patients is at greatest risk for having BPH?

A

An 80-year-old African American male.

Risk factors for BPH include *age, family history, dietary (high fat and meat intake), hormonal, and African American race. In the example, the patient has both age and race.

83
Q

Based on your understanding of the patho of BPH, what type of drug therapy would be recommended for the patient

A

administer drugs that block the conversion of testosterone to DHT.

There are already increasing estrogen levels in men as they age. This promotes prostate cell growth. More testosterone would result in more DHT, which the man does not need. He needs less DHT—so give drugs to block the conversion of testosterone into DHT.

84
Q

If someone has gallbladder issues, the pain should be present after eating which of the following food/drink items?

A

Bowl of Ice cream

bile, which is stored in the GB gets released by the presence of fat in the duodenum. Ice cream has a high fat content

85
Q

A patient is admitted with choledocholithiasis. The nurse understands this to mean what is occurring in this patient.

A

There is a stone in the common bile duct.

86
Q

Which of the following patients is most likely to develop cholecystitis?

A

A 50-year-old woman who has type II diabetes and is overweight.

87
Q

What can happen as a result of cholecystitis

A

ischemia and possible necrosis of the gallbladder, chronic cholecystitis, cholecystectomy, gallstone pancreatitis, cholangitis, hepatitis

88
Q

What causes the pain of pancreatitis?

A

The pancreas is being digested by the pancreatic enzymes and this causes pain.

89
Q

Which of the following are possible complications from pancreatitis?

A

death, shock, hemorrhage, ARDS

90
Q

What is one reason why individuals diagnosed with pancreatic cancer have such a high mortality rate?

A

The cancer usually doesn’t have any symptoms until it has spread.

91
Q

What is the underlying pathology to both Ulcerative Colitis and Crohn’s disease?

A

Inflammation

92
Q

Which disease most commonly affects the small intestine and causes skip lesions in the bowel?

A

Crohn’s Disease

93
Q

Which of the following are symptoms of Crohn’s disease?

A

Abdominal pain, weight loss, malnutritionn, and low grade fever

94
Q

A patient develops a passage from their bowel that connects to the bladder. The nurse recognizes this as:

A

Fistula

95
Q

A characteristic of ulcerative colitis is:

A

confluent ulcers

96
Q

What would you expect to see in a patient with Ulcerative colitis?

A

Many trips to the bathroom because of tenesmus

97
Q

Which patients are at high risk for colon cancer?

A

Pt with ulcerative colitis

98
Q

What type of obstruction of the bowel occurs after surgery from anesthesia or drugs?

A

paralytic ileus

99
Q

What is scar tissue that causes areas of the intestines to adhere together called?

A

adhesion

100
Q

If a patient has a bowel obstruction, which of the following should be a primary concern of the nurse?

A

Fluid and electrolyte imbalance

This can lead to hypovolemic shock and fluids shift spaces. Massive loss of fluids can occur as well as acid-base imbalances

101
Q

What contributes to the formation of diverticuli in the bowel?

A

lack of fiber in diet

102
Q

Which of the following GI situations would patients present with a symptom of low grade temperatures?

A

appendicitis, diverticulitis, and ulcerative colitis

103
Q

If the liver is hard and small on ultrasound, the nurse understands the damage to the liver is at what stage?

A

Chronic inflammation

initial inflammation makes the liver large, long term inflammation leads to a small, hard liver for example in diseases like chronic hepatitis C

104
Q

Which patient is most likely to have typical symptoms of hepatitis?

A

Hep A

The types of hepatitis where the body is able to eradicate the infection are the ones that are most likely to have symptoms. The types of hepatitis that are chronic are less likely to have symptoms.

105
Q

If someone has hepatitis. What symptoms might they have?

A

RUQ pain, anorexia, nausea, fatigue, jaundice

106
Q

What stage of hepatitis is the patient in they do not have jaundice yet?

A

Prodromal phase

This is the first stage and patients may be symptomatic but aren’t jaundiced yet

107
Q

What type of hepatitis causes the most liver cancer and liver cirrhosis?

A

Hep C

108
Q

Which of following types of hepatitis is there an immunization available to prevent infection

A

Hep A and B

109
Q

It is now recommended by the CDC to test baby boomers for which type of hepatitis?

A

Hep C

110
Q

Which of the following statements is true about nonalcoholic steatohepatitis?

A

It is just as detrimental as cirrhosis and is related to poor dietary intake.

111
Q

Albumin is made in the liver, therefore patients with cirrhosis will have what symptoms?

A

Edema, ascites and low blood pressure

112
Q

Why are cirrhosis patients at risk for bleeding? (This is one of the reasons)

A

Low levels of vitamin K due to difficulty absorbing fat

113
Q

What type of patient would have an intrahepatic jaundice?

A

cirrhosis

114
Q

If bile is not able to be conjugated and reach the small intestine, the stool will be what color?

A

Clay

115
Q

Dark colored urine in a patient with jaundice indicates what?

A

Bilirubin is causing the urine to be dark in color

116
Q

If a patient has a dysfunctional liver and portal hypertension has developed, what are other possible problems from portal hypertension?

A

ascites, esophageal varices, peritonitis, hemorrhoids, caput medusae

117
Q

What might cause a patient to develop hepatic encephalopathy?

A

Diet high in protein, GI bleed, infection

118
Q

What impact can cirrhosis have on the kidneys?

A

pre-renal failure

With cirrhosis, the intravascular (blood vessel) volume decreases as the fluid moves into the interstitial space (edema). This decrease intravascular volume results in low blood pressure and also low blood flow to the kidneys. Low blood flow to the kidneys can cause pre-renal failure.

119
Q

A chart reveals the patient has GERD. The nurse knows this to mean:

A

The lower esophageal sphincter is allowing acid to reflux into the esophagus.

120
Q

A patient reports stomach irritation from drinking too much alcohol last night. The patient is diagnosed with

A

Gastritis

121
Q

A neighbor is telling you his stomach protrudes above his diaphragm and causes indigestion symptoms. He plans to have surgery soon. The nurse recognizes this as:

A

Hiatal hernia

122
Q

Which of the following individuals would be most likely (highest risk) of having endometriosis?

A

Someone who started having menstrual cycles at age 8.

Earlier periods, later menopause, longer bleeding times with shorter menstrual cycles increases risk.

123
Q

Earlier periods, later menopause, longer bleeding times with shorter menstrual cycles increases risk.

A

Tissue that should be in the uterus is found in other areas and goes through changes with the menstrual cycle.

124
Q

A patient tells the nurse that she has adhesions from endometriosis. The nurse understands this to be:

A

scar tissue

125
Q

A patient tells the nurse that she has adhesions from endometriosis. The nurse understands this to be:

A

dysmenorrhea

126
Q

A woman is having a speculum exam with a specimen taken for a pap smear. The goal is to take a sample of which cervical cells for evaluation under a microscope to look for cervical cancer changes?

A

Cells in the transformation zone * Area that is highest risk of becoming cancerous.

127
Q

A woman needs to be tested for human papilloma virus. What test should be done?

A

A cell sample from the cervix and tested for HPV

Remember HPV testing is not the same as a pap smear, but is an additional sample that is taken from the cervix.

128
Q

A 16-year old female starts to become sexually active for the first time and contracts HPV infection. What does the nurse expect to happen?

A

The patient’s body will most likely eradicate the virus on its own.

129
Q

Which of the following are caused by the HPV virus

A

genital and plantar warts, some rectal cancers

130
Q

Which of the following pathology reports has the most dysplastic changes?

A

CIN 3

this is severe dysplasia and carcinoma in situ. This is cervical cancer stage 0 which means that it will advance to invasive cervical cancer if left alone.

131
Q

Which of the following men are at greatest risk of prostate cancer?

A

85-year-old male

Age alone is one of the strongest risk factors for cancer. We know that 1 in 6 men have prostate cancer by the age of 85.

132
Q

A patient is diagnosed with advanced prostate cancer that has metastasized. What is the most likely presentation for this type of patient?

A

complaints of BPH-like symptoms as well as pain in the lower back and pelvis

Once advanced, BPH symptoms are common as well as signs of mets. Mets to the bones is common and may present as lower back or pelvic pain.

133
Q

A patient had a PSA done 1 year ago and it was 1.5 ng/mL. A repeat test this year resulted in 25 ng/mL. How would the nurse interpret this information?

A

That is a significant change in PSA levels and needs further investigation to rule out cancer.

Was a digital rectal exam done prior to drawing the blood? This result is concerning and is a significant increase in a 1-year time period. This could be related to doing a digital rectal exam right before drawing the blood. The nurse should recognize that this is a significant increase and should be further investigated.

134
Q

Which of the following situations is most suspicious of testicular cancer?

A

A 22-year-old male with a painless mass found incidentally during self-exam.

135
Q

Which woman would be at highest risk of breast cancer due to estrogen exposure risk?

A

A woman who was on hormone replacement therapy for 20 years.

136
Q

A woman has been diagnosed with ER positive breast cancer. What does this mean?

A

The cancer will most likely respond to targeted hormone therapy that targets estrogen receptors.

137
Q

A nurse is teaching an individual to do monthly self-exams of the breast to look for signs of breast cancer. What should the nurse teach the client to watch for?

A

Asymmetry in the breasts, discharge from the nipple, skin that has an orange peel appearance, painful lumps in the breast

138
Q

A nurse is teaching an individual to do monthly self-exams of the breast to look for signs of breast cancer. What should the nurse teach the client to watch for?

A

Wear gloves when assessing the patient.

HSV causes cold sores and is contagious. It can spread to the hands of the healthcare worker.

139
Q

A patient has genital herpes. What clinical presentation does the nurse expect when examining the patient?

A

There is itching and painful sensations that occurred prior to the outbreak of lesions.

140
Q

What is the most typical scenario for a patient with Chlamydia?

A

The infection was found incidentally during a vaginal swab exam.

141
Q

A patient tells the nurse that he has noticed a lesion on his penis that is moist and does not hurt. The nurse is suspicious that this is might be which STI?

A

syphilis

142
Q

A patient has a rash on the soles of his feet. The nurse recognizes this can occur with which stage of syphilis?

A

secondary

143
Q

A hospitalized patient who has been treated for a major systemic infection (sepsis) with multiple antibiotic drugs is at risk of developing which infection?

A

candidiasis

144
Q

The nurse recognizes that a patient with creamy yellowish-white discharge from his penis may have which STI?

A

gonorrhea

145
Q

What name would be given to a patient who has an involuntary release of urine due to intoxication?

A

transient incontinence

146
Q

The bladder involuntary contracts when a patient has _____________incontinence.

A

urge

147
Q

Patients with neurological disorders such as multiple sclerosis are most at risk for what type of incontinence?

A

urge

148
Q

Patient’s with benign prostatic hypertrophy have difficulty emptying the bladder and it results in _____________incontinence.

A

overflow

149
Q

Who is at risk for incontinence?

A

Pregnancy *
Obesity *
80-year-old female *.

Age is a risk factor due to weakened pelvic floor muscles. This is not “normal” but is a risk factor.

65-year-old patient with COPD * Due to coughing
50-year-old female with urinary tract infection *

150
Q

Why are patients with a urinary catheter more at risk of getting a UTI?

A

Biofilm formation on the catheter surface

151
Q

A patient complains of dysuria. What does this mean?

A

painful urine

152
Q

Looking at a urinalysis, which finding is suggestive of a urinary tract infection?

A

positive leukocyte esterase

153
Q

What hormones are involved in prostate proliferation in BPH?

A

Estrogen and dihydrotestosterone

154
Q

Which of the following are symptoms of BPH?

A

urgency, frequency, difficulty causing stream

155
Q

Which of the following patients is exhibiting symptoms of BPH?

A

void 5 times a night

156
Q

What type of renal failure would the nurse expect in a patient with a history of BPH?

A

post renal failure

157
Q

What does a normal prostate feel like?

A

smooth and equal

158
Q

A patient develops acute renal injury (aka acute renal failure) as a result of taking too much NSAIDS like ibuprofen. Why did this happen?

A

NSAIDS block prostaglandin synthesis resulting in decreased blood flow to the kidney.

159
Q

A patient is in acute renal failure. What do you expect to see on the lab report?

A

Ratio of 15:1 BUN to Creatinine

160
Q

Which of the following patient with acute renal injury (acute renal failure) would most likely have an intra-renal problem?

A

Nephrotoxic drug ingestion

161
Q

Which of the following is a normal GFR?

A

120 ml/min

162
Q

A patient is in CKD Stage 3. What does the nurse expect?

A

Alterations in BUN and creatinine levels and GFR decreased

163
Q

If a patient has protein (albumin) in their urine, what does that tell us?

A

There is damage to the glomerulus.

164
Q

What potassium value would you expect in a stage 5 CKD patient (GFR of 5) who has missed dialysis for 3 days?

A

6.0 mEq/L

165
Q

expected or unexpected

BP 90/50 with CKD 5

A

unexpected

166
Q

expected or unexpected

Jugular vein distention

A

expected

167
Q

expected or unexpected

Hungry all the time (polyphagia)

A

unexpected

168
Q

expected or unexpected

high blood sugars

A

unexpected

169
Q

expected or unexpected

3+ pitting lower extremity edema

A

expected

Pathophysiology (7 decks)

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